二羟丙茶碱预处理对支气管麻醉手术肺保护作用的研究  

Protective Effect of Diprophylline Pretreatment on Lung during Bronchial Anesthesia

作　　者：卢晶 郭红[1] 刘海萍[1] 曾凡荣[1] LU Jing;GUO Hong;LIU Haiping(First Affiliated Hospital of Jiamusi University,Jiamusi 154000,China)

机构地区：[1]佳木斯大学附属第一医院,黑龙江佳木斯154000

出　　处：《中国医学创新》2018年第5期49-52,共4页Medical Innovation of China

摘　　要：目的:探讨二羟丙茶碱预处理对支气管麻醉手术肺保护作用的研究。方法:将2016年11月-2017年9月在本院外科行择期肺叶切除手术的60例患者按照随机数字表法分为两组,均采用全身麻醉,在麻醉诱导前,观察组静脉注射二羟丙茶碱,对照组给予等量生理盐水,比较两组呼吸力学指标、动脉血气指标、肺灌洗液中IL-8和IL-10的浓度、循环指标。结果:记录气管插管前(T1)、插管后(T2)、单肺通气后60 min(T3)各指标,观察组潮气量(VT)、气道平台压(Pplat)、气道峰压(Ppeak)、呼气末正压(PEEP)、肺有效动态顺应性(Cdyn)与对照组相比,差异均有统计学意义(P<0.05);观察组血氧分压(PO_2)、氧合指数(OI)、肺泡-动脉血氧分压差[P(A-a)DO_2]与对照组相比,差异均有统计学意义(P<0.05);分别于插管后(T4)、单肺通气后30 min(T5)、单肺通气后90 min(T6)测定灌洗液中IL-8和IL-10变化,观察组IL-8和IL-10水平均明显低于对照组,差异均有统计学意义(P<0.05);T1~T3中,观察组平均动脉压(MAP)、中心静脉压(CVP)和心率(HR)均明显较对照组控制平稳,差异均有统计学意义(P<0.05)。结论:二羟丙茶碱预处理对支气管麻醉手术肺保护作用确切,能有效减轻机械通气的肺功能损伤,增加肺顺应性,保持氧合水平的稳定,降低气道阻力,具有积极的临床意义。Objective:To investigate the protective effect of Diprophylline pretreatment on lung during bronchial anesthesia.Method:From November 2016 September 2017 in our hospital 60 patients underwent lobectomy surgery were randomly divided into two groups,general anesthesia,before induction of anesthesia,the observation group was given Diprophylline intravenous injection,the control group was received normal saline,the respiratory mechanics index,arterial blood gas and IL-8 and IL-10 in lung lavage fluid of two groups were compared.Result:Before tracheal intubation(T1),after intubation(T2),60 min after one lung ventilation(T3),tidal volume(VT),plateau airway pressure(Pplat),peak airway pressure(Ppeak),positive end expiratory pressure(PEEP)and lung dynamic compliance(effective Cdyn)of the observation group compared with the control group,there were statistical significance(P<0.05).PO2,oxygenation index(OI),alveolar arterial oxygen difference[P(A-a)DO2]of the observation group compared with the control group,the differences were statistically significant(P<0.05).After intubation(T4),one lung ventilation 30 min(T5),one lung ventilation 90 min(T6),IL-8 and IL-10 in lung lavage fluid changes were observed,IL-8 and IL-10 of the observation group were significantly lower than those of the control group,the differences were statistically significant(P<0.05).T1-T3,HR,MAP,CVP of the observation group were significantly better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Diprophylline pretreatment on bronchial lung protective effect of surgical anesthesia is effective,can effectively reduce the mechanical ventilation pulmonary function injury,increase lung compliance,maintain oxygenation level stability,reduce airway resistance,has a positive clinical significance.

关 键 词：支气管麻醉手术 二羟丙茶碱预处理 肺保护作用 

分 类 号：R614[医药卫生—麻醉学]